[Dysphagia] Hydrogen peroxide

[eripley at yahoo.com (Irene Campbell-Taylor)]

The effects of hydrogen peroxide rinses on the normal oral mucosa. Nurs Res. 1993 Nov-Dec;42(6):332-7.

Tombes MB, Gallucci B.

Louis P. Batson, Jr., Cancer Care Center, St. Francis Hospital, Greenville, SC.

Oral mucosal effects of hydrogen peroxide mouth rinses were investigated in normal volunteers. Following a 2-week control period, 35 subjects were randomly assigned to rinse with either normal saline, 1/4-strength hydrogen peroxide (0.75%), or 1/2-strength hydrogen peroxide (1.5%), 4 times daily for 2 weeks. Mucosal status, buccal microbial adherence, salivary flow rate (SFR), and subjective reactions were assessed weekly. In the normal saline group, no significant changes were noted in any of the observed parameters and subjective reports were unremarkable. In both hydrogen peroxide groups, significant mucosal abnormalities were observed (p < 0.001) and subjective complaints were numerous. Bacterial adherence was significantly reduced in the 1/4 hydrogen peroxide group but not in the 1/2 hydrogen peroxide group. Despite reports of dry mouth, SFRs were not altered significantly. Since hydrogen peroxide rinses are associated with mucosal abnormalities and elicit
 overwhelmingly negative subjective reactions in normal individuals, they are not recommended for oral care.
  
Clinical evaluation of the effect of a hydrogen peroxide mouth rinse, sodium bicarbonate dentifrice, and mouth moisturizer on oral health.
J Clin Dent. 1997;8(5):145-9.
Shibly O, Ciancio SG, Kazmierczak M, Cohen RE, Mather ML, Ho A, Bessinger M.

School of Dental Medicine, State University of New York at Buffalo, USA.

The objective of this 60-day single-blind, parallel trial, using 150 subjects, was to evaluate the effect of a 20% sodium bicarbonate dentifrice, a 1.5% hydrogen peroxide solution and a mouth moisturizer on oral tissues and microflora. Subjects were randomly assigned to one of five groups. The treatments were: 1) Sage dentifrice (sodium bicarbonate). Toothette Plus containing baking soda saturated with the hydrogen peroxide solution and use of a mouth moisturizer, 2) Crest dentifrice, Toothette Plus containing baking soda saturated with the hydrogen peroxide solution and use of a mouth moisturizer, 3) Crest dentifrice, Toothette Plus containing baking soda with a control solution and no mouth moisturizer, 4) Crest dentifrice, Toothette (without baking soda), saturated with a control solution and no mouth moisturizer, and 5) Crest dentifrice, Toothette saturated with 1.5% flavored H2O2 and no mouth moisturizer. From a subgroup of 35 patients (seven from each group) buccal
 smears for exfoliative cytology were taken as were supragingival microbiological samples from the mesial aspect of first molars (pooled). Buccal smears were evaluated for signs of histopathological changes. Microbiological samples from supra- and subgingival plaque for P. gingivalis, P. intermedia, A. actinomycetemcomitans. A viscosus, F. nucleatum, F. sanguis and C. albicans were evaluated. Clinical parameters measured were a stain index (SI), the modified gingival index (MGI), and a plaque index (PI). There were no adverse changes in the oral microflora and no anaplastic or other pathological changes in any subjects. Clinical parameters showed a statistically significant reduction in the MGI ranging from 26.7-29.9% with no significant differences among the groups (p > 0.05). The PI showed small reductions in all groups except group 2, but the differences were not statistically significant from each other or baseline (p > 0.05). The SI revealed slight increases in all
 groups and no differences among the groups. It can be concluded that use of Sage dentifrice, Toothette Plus saturated with Perox-A-Mint and Sage Mouth Moisturizer are safe to oral tissues. Using these components did not result in clinically noticeable stain formation, promote plaque formation, or produce any significant adverse changes in the oral microflora.
          Oral Microbiology and Immunology
Volume 20 Page 31  - February 2005


      Comparative analysis of the antibacterial effects of combined mouthrinses on Streptococcus mutans
      A. Menendez1,5, F. Li2, S. M. Michalek3, K. Kirk4, S. K. Makhija2, N. K. Childers2
      Menendez A, Li F, Michalek SM, Kirk K, Makhija SK, Childers NK. Comparative analysis of the antibacterial effects of combined mouthrinses on Streptococcus mutans. 
Oral Microbiol Immunol 2005: 20: 31?34. 
  Background/aims: Chlorhexidine has been proposed as a potent chemotherapeutic agent against oral bacteria. However, there are some inconsistent results regarding the usefulness of chlorhexidine mouthrinse as an antimicrobial for Streptococcus mutans. The purpose of this study was to investigate the effectiveness of combining oral rinses to reduce S. mutans levels in human saliva.
  Methods: Sixteen healthy adult subjects were randomly assigned to one of four rinse groups using a 4-cell crossover design. The groups rinsed twice a day for 7 days with one of the following: 0.12% chlorhexidine (PerioGard?), 1.5% hydrogen peroxide (Peroxyl?), a combined chlorhexidine + hydrogen peroxide, or water (control). Every 5 weeks, each group initiated a different rinse. Saline wash samples were collected on days 7 and 21 for assessment of S. mutans and total streptococci.
  Results: No significant differences were seen in S. mutans levels among the groups; however, the levels of total streptococci on day 7 samples were significantly lower in the chlorhexidine and chlorhexidine + hydrogen peroxide groups than in the hydrogen peroxide and control groups. There was no additional decrease seen in S. mutans or total streptococci levels in the group receiving chlorhexidine + hydrogen peroxide compared to chlorhexidine alone.
  Conclusions: Sample variation was high throughout the study, with a significant trend toward lower counts as the study progressed. Adding hydrogen peroxide to the chlorhexidine mouthrinse did not result in a further decrease in S. mutans levels.
   


Dr I Campbell-Taylor
Clinical Neuroscientist
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